16 results on '"Bolwell, B. J."'
Search Results
2. Primary graft failure after myeloablative allogeneic hematopoietic cell transplantation for hematologic malignancies
- Author
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Olsson, R. F., Logan, B. R., Chaudhury, S., Zhu, X., Akpek, G., Bolwell, B. J., Bredeson, C. N., Dvorak, C. C., Gupta, V., Ho, V. T., Lazarus, H. M., Marks, D. I., Ringden, O. T. H., Pasquini, M. C., Schriber, J. R., Cooke, K. R., Olsson, R. F., Logan, B. R., Chaudhury, S., Zhu, X., Akpek, G., Bolwell, B. J., Bredeson, C. N., Dvorak, C. C., Gupta, V., Ho, V. T., Lazarus, H. M., Marks, D. I., Ringden, O. T. H., Pasquini, M. C., Schriber, J. R., and Cooke, K. R.
- Abstract
Clinical outcomes after primary graft failure (PGF) remain poor. Here we present a large retrospective analysis (n = 23 272) which investigates means to prevent PGF and early detection of patients at high risk. In patients with hematologic malignancies, who underwent their first myeloablative allogeneic hematopoietic cell transplantation, PGF was reported in 1278 (5.5%), and there was a marked difference in PGFs using peripheral blood stem cell compared with bone marrow grafts (2.5 vs 7.3%; P<0.001). A fourfold increase of PGF was observed in myeloproliferative disorders compared with acute leukemia (P<0.001). Other risk factors for PGF included recipient age <30, HLA mismatch, male recipients of female donor grafts, ABO incompatibility, busulfan/cyclophosphamide conditioning and cryopreservation. In bone marrow transplants, total nucleated cell doses <= 2.4 x 10(8) per kg were associated with PGF (odds ratio 1.39; P<0.001). The use of tacrolimus-based immunosuppression and granulocyte colony-stimulating factor were associated with decreased PGF risk. These data, allow clinicians to do more informed choices with respect to graft source, donor selection, conditioning and immunosuppressive regimens to reduce the risk of PGF. Moreover, a novel risk score determined on day 21 post transplant may provide the rationale for an early request for additional hematopoietic stem cells.
- Published
- 2015
- Full Text
- View/download PDF
3. A 68-year-old woman with high serum protein and no symptoms
- Author
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LONGWORTH, D. L., primary, STOLLER, J. K., additional, ABDEL-RAZEQ, H., additional, and BOLWELL, B. J., additional
- Published
- 1997
- Full Text
- View/download PDF
4. The elevated peripheral white blood count
- Author
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Longworth, D. L., primary, Stoller, J. K., additional, and Bolwell, B. J., additional
- Published
- 1993
- Full Text
- View/download PDF
5. The use of G-CSF and GM-CSF in bone marrow transplantation
- Author
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Vidt, D. G., primary, Bakst, A., additional, and Bolwell, B. J., additional
- Published
- 1993
- Full Text
- View/download PDF
6. Bone Marrow Transplantation: Updated Indications
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Wilke, W. S., primary and Bolwell, B. J., additional
- Published
- 1990
- Full Text
- View/download PDF
7. The effect of pretransplant interferon therapy on the outcome of unrelated donor hematopoietic stem cell transplantation for patients with chronic myelogenous leukemia in first chronic phase.
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Lee SJ, Klein JP, Anasetti C, Antin JH, Loberiza FR, Bolwell BJ, LeMaistre CF, Litzow MR, Marks D, Waller EK, Matlack M, Giralt S, and Horowitz MM
- Subjects
- Acute Disease, Adolescent, Adult, Antibodies, Viral blood, Chronic Disease, Cytomegalovirus immunology, Disease-Free Survival, Female, Graft vs Host Disease epidemiology, Humans, Interferons administration & dosage, Leukemia, Myelogenous, Chronic, BCR-ABL Positive mortality, Male, Middle Aged, Recurrence, Registries, Survival Rate, Time Factors, Hematopoietic Stem Cell Transplantation, Interferons therapeutic use, Leukemia, Myelogenous, Chronic, BCR-ABL Positive therapy, Treatment Outcome
- Abstract
Various therapeutic options are available for patients with chronic myelogenous leukemia. Allogeneic stem cell transplantation, though often curative, is associated with high nonrelapse mortality and long-term morbidity, particularly when cells from unrelated donors are used. Many physicians and patients opt for a trial of interferon-alpha (IFN)-based therapy first, reserving transplantation for patients with inadequate response or intolerance to IFN. Data were analyzed on 740 patients receiving unrelated donor transplants for chronic myelogenous leukemia in first chronic phase provided by the International Bone Marrow Transplant Registry and the National Marrow Donor Program to see whether IFN pretreatment compromised transplantation outcome. A total of 489 (66%) had received IFN prior to transplantation; 251 (34%) had not. Disease characteristics in the 2 groups were similar at diagnosis but at the time of transplantation, hematologic parameters and weight were lower in IFN patients and the interval between diagnosis and transplantation was longer. After adjustment for baseline covariates, no effect of IFN exposure was found on overall survival, leukemia-free survival, nonrelapse mortality, engraftment, relapse, or acute or chronic graft-versus-host disease. Evaluation of effects based on duration of therapy and time off IFN prior to transplantation was limited by missing data and confounding with IFN intolerance and disease responsiveness. In conclusion, no evidence was found for an independent adverse effect of IFN pretreatment on the outcome of subsequent unrelated donor transplantation.
- Published
- 2001
- Full Text
- View/download PDF
8. Treatment of steroid-refractory acute graft-versus-host disease with anti-CD147 monoclonal antibody ABX-CBL.
- Author
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Deeg HJ, Blazar BR, Bolwell BJ, Long GD, Schuening F, Cunningham J, Rifkin RM, Abhyankar S, Briggs AD, Burt R, Lipani J, Roskos LK, White JM, Havrilla N, Schwab G, and Heslop HE
- Subjects
- Acute Disease, Adolescent, Adult, Antibodies, Monoclonal pharmacokinetics, Antibodies, Monoclonal toxicity, Antineoplastic Agents pharmacokinetics, Antineoplastic Agents toxicity, Basigin, Child, Child, Preschool, Dose-Response Relationship, Drug, Drug Resistance, Half-Life, Humans, Infant, Lymphocyte Subsets, Middle Aged, Steroids therapeutic use, Survival Analysis, Therapeutic Equivalency, Antibodies, Monoclonal administration & dosage, Antibodies, Monoclonal therapeutic use, Antigens, CD, Antigens, Neoplasm, Antigens, Surface, Antineoplastic Agents administration & dosage, Avian Proteins, Blood Proteins, Graft vs Host Disease drug therapy, Membrane Glycoproteins immunology
- Abstract
ABX-CBL, an immunoglobulin M murine monoclonal antibody, recognizes CD147 and initiates cell killing through complement-mediated lysis. In a dose-finding trial, 27 patients with steroid-refractory acute graft-versus-host disease (GVHD) received ABX-CBL at 0.01 (presumed no effect dose), 0.1, 0.2, or 0.3 mg/kg per day, and an additional 32 patients were given ABX-CBL at 0.2 or 0.15 mg/kg per day. All patients had undergone allogeneic transplantation for malignant or nonmalignant disorders and received GVHD prophylaxis, generally with methotrexate- and cyclosporine-containing regimens. None responded to methylprednisolone, given for a minimum of 3 days. ABX-CBL was started 20 to 236 (median, 47) days after transplantation; it was given for 7 consecutive days and was followed by 2 infusions per week for 2 more weeks. Among 51 patients evaluable for efficacy, 26 (51%) responded, including 13 with complete responses (CR) and 13 with partial responses (PR). CR lasting 14 days or longer or PR lasting 7 days or longer occurred in 21 (41%; 8 CR, 13 PR) patients, including 19 of 43 (44%) patients who received 0.1 to 0.3 mg/kg ABX-CBL and 2 of 8 (25%) patients given 0.01 mg/kg per day. Myalgias at doses 0.2 mg/kg or greater were dose limiting and resolved without sequelae. Causes of death included organ failure, progressive GVHD, and infection. No death was attributed to ABX-CBL. At 6 months after the initiation of ABX-CBL therapy, 26 (44%) patients were surviving. These results are encouraging. Further studies on the use of ABX-CBL in the management of GVHD are warranted.
- Published
- 2001
- Full Text
- View/download PDF
9. Routine cultures of bone marrow and peripheral stem cell harvests: clinical impact, cost analysis, and review.
- Author
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Nasser RM, Hajjar I, Sandhaus LM, Hall GS, Avery RK, Bolwell BJ, Longworth DL, and Adal KA
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- Adult, Bacterial Infections microbiology, Bacterial Infections prevention & control, Bone Marrow Cells cytology, Bone Marrow Transplantation economics, Health Care Costs, Hematopoietic Stem Cells cytology, Humans, Middle Aged, Mycoses microbiology, Mycoses prevention & control, Retrospective Studies, Bone Marrow Cells microbiology, Bone Marrow Transplantation adverse effects, Cell Culture Techniques economics, Cell Culture Techniques standards, Hematopoietic Stem Cells microbiology
- Abstract
The American Association of Blood Banks requires routine culture of hematopoietic progenitor cells prior to bone marrow transplantation. We sought to evaluate the cost of that requirement and the incidence and clinical significance of positive cultures. We performed a retrospective analysis of transplant recipients at our institution. Of the 605 patients for whom 1,934 consecutive cultures of harvests were done between December 1992 and February 1996, 11 had positive cultures. Six patients received a culture-positive harvest with no adverse effects. The total cost of cultures was $35,660 (U.S. $). In North America and worldwide in 1995, routine culture of harvests would have prevented 7.9 and 18.9 cases of bacteremia, respectively, at a cost of $95,000 per bacteremia prevented. We conclude that routine culture of hematopoietic progenitor cells yields low rates of positivity and that infusion of contaminated harvests rarely results in clinically adverse outcomes.
- Published
- 1998
- Full Text
- View/download PDF
10. A 68-year-old woman with high serum protein and no symptoms.
- Author
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Abdel-Razeq H and Bolwell BJ
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- Aged, Bone Marrow Examination, Bone and Bones diagnostic imaging, Diagnosis, Differential, Electrophoresis, Female, Humans, Radiography, Blood Proteins analysis, Paraproteinemias diagnosis
- Published
- 1997
- Full Text
- View/download PDF
11. The elevated peripheral white blood count.
- Author
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Bolwell BJ
- Subjects
- Female, Humans, Leukemia, Lymphocytic, Chronic, B-Cell blood, Leukemia, Myelogenous, Chronic, BCR-ABL Positive blood, Leukemia, Myeloid, Acute blood, Leukocyte Count, Male, Middle Aged, Pneumonia blood, Primary Myelofibrosis blood, Leukocytosis diagnosis
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- 1993
- Full Text
- View/download PDF
12. The use of G-CSF and GM-CSF in bone marrow transplantation.
- Author
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Bolwell BJ
- Subjects
- Combined Modality Therapy, Graft Survival drug effects, Hematopoietic Stem Cells drug effects, Humans, Transplantation, Autologous, Transplantation, Homologous, Bone Marrow Transplantation, Granulocyte Colony-Stimulating Factor therapeutic use, Granulocyte-Macrophage Colony-Stimulating Factor therapeutic use, Hematologic Diseases therapy
- Abstract
Bone marrow transplantation is accepted as potentially curative therapy for a variety of patients with hematologic malignancies and other disorders. The most important causes of morbidity are infections and bleeding secondary to prolonged cytopenias. Granulocyte colony stimulating factor (G-CSF) and granulocyte-macrophage colony stimulating factor (GM-CSF) have been shown to potentially enhance bone marrow engraftment which has translated into reduced morbidity and mortality. Additionally, growth factors such as G-CSF and GM-CSF may increase numbers of circulating peripheral progenitor cells to serve as the source of "marrow" for transplantation. This review summarizes the current available data using G-CSF and GM-CSF in bone marrow transplantation and discusses potential areas of study with additional cytokines.
- Published
- 1993
- Full Text
- View/download PDF
13. Experiences of the first 493 unrelated marrow donors in the National Marrow Donor Program.
- Author
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Stroncek DF, Holland PV, Bartch G, Bixby T, Simmons RG, Antin JH, Anderson KC, Ash RC, Bolwell BJ, and Hansen JA
- Subjects
- Adult, Female, Humans, Male, Middle Aged, United States, Bone Marrow Transplantation, Tissue Donors, Tissue and Organ Procurement
- Abstract
More than 410,000 people participated in the National Marrow Donor Program (NMDP) as of October 1, 1991, and more than 850 volunteers had donated marrow. While the incidence of serious morbidity as a result of bone marrow donation is rare, the incidence of lesser complications and the long-term consequences of marrow donation are not known. To determine the incidence of donor complications and measure the recovery time of volunteer, unrelated marrow donors, we analyzed the results of surveys of the first 493 persons who donated marrow through the NMDP. The marrows were collected at 42 centers. The median age of the donors was 37.9 years (range 19.1 to 55.6 years). The median volume of marrow collected was 1,050 mL (range 180 to 2,983 mL). Autologous red blood cells were transfused to 89.8% (439) of donors but only 0.6% (3) of donors received allogeneic blood. Acute complications related to the collection procedure occurred in 5.9% of donors; but a serious complication, apnea during anesthesia, occurred in only one donor. When donors were questioned approximately 2 days following discharge from their hospitalization, most donors described symptoms related to the collection; 74.8% experienced tiredness, 67.8% experienced pain at the marrow collection site, and 51.6% of the donors experienced low back pain. Donors were surveyed repeatedly until they felt that they had recovered completely. Mean recovery time was 15.8 days; however, 42 (10%) donors felt that it took them > or = 30 days to recover fully. The duration of the marrow collection procedure and duration of anesthesia both positively correlated with donor pain and/or fatigue following the collection; but the duration of the collection procedure had the highest correlation with post-collection pain and fatigue. The volume of marrow collected per unit of donor weight was more weakly correlated with donor pain and/or fatigue than the anesthesia and collection times. When multivariate analysis was used to analyze the correlation between donor recovery time and these variables, only the duration of the collection was found to correlate significantly with donor recovery time (P = .001). This analysis demonstrates that marrow donation is well tolerated with few complications. To decrease further the incidence of donor discomfort and recovery time following donation, the duration of the collection procedure, and probably the duration of anesthesia, and the volume of marrow collected, should be kept to a minimum.
- Published
- 1993
14. High-dose cytarabine and daunorubicin induction and postremission chemotherapy for the treatment of acute myelogenous leukemia in adults.
- Author
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Phillips GL, Reece DE, Shepherd JD, Barnett MJ, Brown RA, Frei-Lahr DA, Klingemann HG, Bolwell BJ, Spinelli JJ, and Herzig RH
- Subjects
- Adult, Antineoplastic Combined Chemotherapy Protocols adverse effects, Cytarabine administration & dosage, Daunorubicin administration & dosage, Female, Follow-Up Studies, Humans, Leukocyte Count, Male, Prognosis, Remission Induction, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Leukemia, Myeloid, Acute drug therapy
- Abstract
Seventy consecutive adult patients with acute myelogenous leukemia (AML), median age 44 years, received high-dose cytarabine (3 g/m2 every 12 hours for 12 doses) followed by daunorubicin (45 mg/m2 daily for three doses) for remission induction. A single, identical course was planned for postremission therapy. Complete remission (CR) was achieved in 63 patients (90%, 95% confidence interval [CI] 83% to 97%), 60 after a single course. Eight patients were selected to undergo elective bone marrow transplantation (BMT) during first CR. Of the remaining 55 patients, 40 (73%) underwent planned post-CR therapy; 15 patients did not, owing to early relapse, excessive toxicity from the induction chemotherapy, or refusal. Nineteen patients, including 13 who received planned post-CR therapy, remain in continuous CR at a median follow-up of 5.2 years (range 3.0 to 7.1 years). The 5-year actuarial leukemia-free survival was 30% (95% Cl, 19% to 42%) for all patients achieving CR and 32% (95% Cl, 19% to 47%) for the 40 patients who received the planned post-CR chemotherapy. Analysis of various putative prognostic factors for CR and overall and leukemia-free survival showed significance for a previous history of myelodysplasia, higher initial leukocyte counts, certain French-American-British (FAB) types, and certain abnormal karyotypes. None of these factors was consistently significant regarding the above parameters, although small patient numbers in certain analyses may have obscured significant associations. Myelosuppression was occasionally prolonged after remission induction and especially post-CR therapy. Severe cerebellar toxicity was observed in 13 patients; in 11 cases, this toxicity was fully reversible. Other serious complications were infrequent. Intensive chemotherapy with high-dose cytarabine and daunorubicin has substantial antileukemic activity in adult AML, and may represent an improvement over conventional therapy. Relapses were common, however, even in patients who received planned therapy, and substantial toxicity was observed. The optimum use of this regimen in AML remains to be determined.
- Published
- 1991
15. High-dose etoposide and cyclophosphamide without bone marrow transplantation for resistant hematologic malignancy.
- Author
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Brown RA, Herzig RH, Wolff SN, Frei-Lahr D, Pineiro L, Bolwell BJ, Lowder JN, Harden EA, Hande KR, and Herzig GP
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- Acute Disease, Blood Cells drug effects, Cyclophosphamide pharmacokinetics, Cyclophosphamide toxicity, Dose-Response Relationship, Drug, Drug Resistance, Drug Therapy, Combination, Etoposide pharmacokinetics, Etoposide toxicity, Hodgkin Disease drug therapy, Humans, Leukemia pathology, Lymphoma pathology, Spleen drug effects, Bone Marrow Transplantation, Cyclophosphamide therapeutic use, Etoposide therapeutic use, Leukemia drug therapy, Lymphoma drug therapy
- Abstract
Seventy-five patients with resistant acute leukemia or lymphoma received high-dose cyclophosphamide and etoposide to explore the activity of this combination in resistant hematologic malignancies, and to determine the maximum doses of these drugs that can be combined without bone marrow transplantation. Etoposide was administered over 29 to 69 hours by continuous infusion corresponding to total doses of 1.8 g/m2 to 4.8 g/m2. Cyclophosphamide, 50 mg/kg/d, was administered on 3 or 4 consecutive days total 150 to 200 mg/kg ideal body weight). At all dose levels myelosuppression was severe but reversible. Mucosal toxicity was dose-limiting with the maximum tolerated dose level combining etoposide 4.2 g/m2 with cyclophosphamide 200 mg/kg. Continuous etoposide infusion produced stable plasma levels that were lower than would be achieved after administration by short intravenous infusion, and this could explain our ability to escalate etoposide above the previously reported maximum tolerated dose. There were 28 complete (35%) and 12 partial (16%) responses. Median duration of complete response (CR) was 3.5 months (range 1.1 to 20+). Seventeen of 40 patients (42%) with acute myelogenous leukemia (AML) achieved CR, including 6 of 20 (30%) with high-dose cytosine arabinoside resistance. We conclude that bone marrow transplantation is not required after maximum tolerated doses of etoposide and cyclophosphamide. This regimen is active in resistant hematologic neoplasms, and the occurrence of CR in patients with high-dose cytosine arabinoside-resistant AML indicates a lack of complete cross-resistance between these regimens.
- Published
- 1990
16. Bone marrow transplantation: updated indications.
- Author
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Bolwell BJ
- Subjects
- Humans, Leukemia, Myeloid, Acute therapy, Transplantation, Homologous, Bone Marrow Transplantation, Neoplasms therapy
- Published
- 1990
- Full Text
- View/download PDF
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